Neuropathic Pain Health-Related Quality of Life is Improved by Spinal Cord Cord Stimulation for Patients with Chronic Neuropathic Pain - UK National Registry Data.
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All Authors
Martin S.
Baranidharan G.
Thomson S.
Gulve A.
Manfield J.
Mehta V.
Jones S.L.
Strachan R.
Bojanic S.
Eldabe S.
LTHT Author
Baranidharan, Ganesan
LTHT Department
Adult Critical Care
Pain Management
Neuromodulation
Pain Management
Neuromodulation
Non Medic
Publication Date
2024
Item Type
Conference Abstract
Language
Subject
SPINAL CORD , CHRONIC PAIN , UNITED KINGDOM , QUALITY OF LIFE , PAIN MANAGEMENT , ANALGESIA
Subject Headings
Abstract
BACKGROUND: Spinal cord stimulation (SCS) is a well-established treatment for chronic neuropathic pain and is supported by numerous studies. However, some recent articles have called its efficacy into question.We examine a cohort of over 1,800 SCS patients from the UK National Neuromodulation Registry. AIMS: To provide a real world assessment of efficacy and compare its effects with other procedures performed for painful indications. METHOD(S): Quality of life (QoL) data (EuroQoL 5 level, EQ5D) and demographic data were extracted from The National Neuromodulation Registry (NNR) for all patients (n=1811) that underwent spinal cord stimulation for chronic pain in 27 centres in the UK between February 2018 and July 2022. These were compared to data from the published literature for other commonly performed elective surgical procedures. RESULT(S): EQ5D utility index increased by a mean of 0.202 in the 1236 patients with paired pre- and post-operative utility scores. The median utility was 0.263 (IQR=0.384; n=1811) pre-operatively, while at 6 months post-operation it was 0.550 (IQR=0.396; n=1025), p -0.0001, Wilcoxon rank sum test. The median utility score at 12 months post-operation was 0.548 (IQR=0.417; n=970). There was no difference in utility scores at 6 months and 12 months after surgery (p=0.15, Wilcoxon rank sum test). There was a significant improvement in quality of life in all 5 domains of the 5 level EQ5D tool at 6 months after baseline (p<0.0001, for all subcategories) and this was sustained at 1 year after surgery. The baseline utility was lower than in other patients undergoing elective surgery for pain, and the absolute (and proportionate) increase in utility following surgery is higher than in most other comparable series. CONCLUSION(S): Spinal cord stimulation effectively increases the quality of life in patients requiring surgery for pain. Similar results were seen regardless of SCS indication. When comparing analogous databases, SCS produces a greater percentage improvement in EQ5D utility than many other elective surgical procedures for painful conditions, including spinal surgery and some joint replacements.
Journal
British Journal of Pain